YOU ASK:

Medigap vs PPO insurance policies: Which is better?

WE ANSWER:

Medigap is an additional insurance that is aimed to supplement the coverage provided by Medicare. This is because Medicare does not provide for everything, especially for deductibles and co-insurance.

On the other hand, a PPO or a Preferred Provider Organization is a type of health insurance that enables you to avail of medical treatment within a network of providers, or even outside the network.

Medigap provides the following features:

  • Medigap provides a number of different plans that provide different types of coverages. What you can actually do is pick the plans you want in order for you to have the coverage that you need. The plans provide basic medical coverage, as well as coverage for prescription drugs, preventive care, surgery and home recovery.
  • It is a coverage that is very affordable.
  • Medigap will also pay for medical treatments that are commonly not covered by Medicare, particularly treatments outside of the country, as well as other elective and preventive treatments.
  • Medigap insurance is sold by private insurance companies.
  • This coverage works only if you have Medicare cover. In some cases, Medigap is sold only to seniors. Thus, if you are not eligible, you cannot avail of this cover.
  • Medigap covers only one person. If you are married, your spouse will need to buy a separate policy.

PPOs offer the following:

  • Treatments are for a predetermined amount. This is what the insurance will cover (less deductibles and co-payments).
  • PPOs have a considerably wider network of medical providers as compared to Medicare and Medigap.

You should be the one who will decide which will be better for your needs. Medigap rules will vary from state to state.

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